Percutaneous Endoscopic Gastrostomy Tube Removal for Patients With Advanced Dementia: Case Series Study

Area of Science:

• Gerontology
• Neurology
• Gastroenterology

Background:

• Percutaneous endoscopic gastrostomy (PEG) placement is common in Japan's aging population with dementia.
• Limited research exists on PEG extubation in dementia patients who regain oral intake.
• This study addresses the need for understanding factors predicting PEG removal in this demographic.

Purpose of the Study:

• To present demographic data of dementia patients successfully extubated from PEG tubes.
• To identify clinical factors associated with successful PEG removal and resumption of full oral intake.
• To explore predictors for weaning from PEG tubes in elderly individuals with dementia.

Main Methods:

• Retrospective case series conducted in a Japanese long-term care hospital.
• Inclusion criteria: age ≥75 years, dementia diagnosis, and resumption of full oral intake post-PEG removal.
• Data collected on patient demographics and clinical course related to PEG extubation.

Main Results:

• Eight female patients aged ≥85 years with advanced dementia were successfully weaned from PEG tubes.
• Acute conditions like infectious enteritis often precipitated decreased oral intake.
• Speech therapists frequently initiated oral intake trials, often with pureed foods.

Conclusions:

• Appropriate guidance and care can enable swallowing function recovery in dementia patients, even with limited life expectancy.
• Regular assessment of swallowing function post-PEG insertion is crucial for successful extubation.
• This case series highlights the potential for PEG tube removal in elderly dementia patients.